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[Gastric cancer 785. Metachronous cancer after ESD for EGC]
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After curative resection of EGC, the recurrence rate of the index cancer is quite low. For the 5 years after the ESD, it is less than 1 percent including extragastric recurrenes and local recurrences. However, metachronous cancer is a big problem. Metachronous cancer is usually 1-2%/year. In addition, metachronous adenoma is additionally 1-3%/year .
After 5 years of ESD, the rate of follow-up loss is high. Without regular screening endoscopy, metachronous cancer is a real threat to the patient.
In this case, ESD for EGC was done as usual, and the follow up was done up to 5 years.
After 5 years, the patient was lost to follow-up. Eleven years after the endoscopic treatment of EGC, a large cancer was found in the proximal stomach. Initial CT scan showed multiple lymph node and hepatic metastasis.
After ESD for EGC, yearly follow-up EGD should be recommended at least until the upper age limit of screening.
© 일원내시경교실 바른내시경연구소 이준행. EndoTODAY Endoscopy Learning Center. Lee Jun Haeng. (2019-8-27)